American Airlines defended its staff as professional and its equipment as sound Monday after a swift review of a passenger's in-flight death, despite her family's claims that the crew ignored her pleas until it was too late.
Carine Desir, 44, was pronounced dead Friday on a nearly full Haiti-to-New York flight by a pediatrician who said he tried to use the plane's defibrillator on her as she faded, but her pulse was already too weak for it to work.
Doctors, nurses stepped in
The doctor, Joel Shulkin, was one of several medical professionals who stepped in after flight attendants asked if any were on board. Shulkin said through his attorney, Justin Nadeau, that two emergency medical technicians performed CPR on Desir, a diabetic.
Sitting in the 10th row, four rows back from first class, Desir had complained of not feeling well and being very thirsty after she ate a meal on the flight home from Port-au-Prince to John F. Kennedy International Airport, according to Antonio Oliver, a cousin who was traveling with her and her brother. A flight attendant brought water to her, he said.
A few minutes later, Desir, herself a nurse, said she was having trouble breathing and asked for oxygen, Oliver said. "Don't let me die," he recalled her saying.
But a flight attendant twice refused her request, Oliver said.
Airline spokesman Charley Wilson said Desir's cousin flagged down a flight attendant and said Desir had diabetes and needed oxygen. "The flight attendant responded, 'OK, but we usually don't need to treat diabetes with oxygen, but let me check anyway and get back to you,'" Wilson said.
The employee spoke with another flight attendant, and both went to Desir within three minutes, according to Wilson.
"By that time the situation was worsening, and they immediately began administering oxygen," he said.
Flight attendants are trained not to automatically give oxygen to every passenger who requests it but instead use airline criteria to judge when it's needed, said Leslie Mayo, a spokeswoman for the union representing American's attendants.
There were 12 oxygen tanks on the plane and the crew checked them before the flight took off to make sure they were working, Wilson said. He said at least two were used on Desir.
"Each tank worked properly. I cannot speculate as to why a second tank was used," he said.
The Federal Aviation Administration requires commercial flights to carry no fewer than two oxygen dispensers. The main goal of the rule is to have oxygen available in case there is a rapid cabin decompression, but it can also be used for other emergencies. It is up to the airlines to maintain the canisters.
Oliver said other passengers — the 267-seat Airbus A300 was carrying 263, the airline said — aboard Flight 896 became agitated over the situation, and the flight attendant tried to administer oxygen from a portable tank and mask, but the tank was empty. Shulkin could not confirm whether the oxygen was flowing, his attorney said.
"It was working, and the defibrillator was applied as well," Wilson said.
An automated external defibrillator delivers an electric shock to try to restore a normal heart rhythm if a particular type of irregular heart beat is detected. The machines cannot help in all cases.
Wilson and Shulkin said the defibrillator indicated Desir's heartbeat was too weak for the unit to work. Shulkin declined to provide additional detail, out of concern for Desir's family.
Oliver said he asked for the plane to "land right away so I can get her to a hospital," and the pilot agreed to divert to Miami, 45 minutes away. But during that time Desir collapsed and died, Oliver said.
"Her last words were, 'I cannot breathe,'" he said.
Flight crew ‘acted admirably’
Wilson said three flight attendants helped Desir, but "stepped back" after doctors and nurses on the flight began to help her.
"Our crew acted very admirably. They did what they were trained to do, and the equipment was working," he said.
Desir was pronounced dead by Shulkin, and the flight continued to New York without stopping. Desir's body was moved to the floor of the first-class section and covered with a blanket, Oliver said.
With Desir's body near the front bulkhead, all passengers left the plane through an exit behind the first-class section. Her body was then removed, Wilson said.
Desir died of complications from heart disease and diabetes, said Ellen Borakove, a spokeswoman for the medical examiner's office.
FAA spokeswoman Alison Duquette said the agency's Federal Air Surgeon's office plans to discuss Desir's death with officials at Fort Worth, Texas-based American Airlines, a unit of AMR Corp.